ArticleBreast cancer research and treatment2018
Digital image analysis of Ki67 proliferation index in breast cancer using virtual dual staining on whole tissue sections: clinical validation and inter-platform agreement.
Article in Breast cancer research and treatment, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers.
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Who cites it
43 citing papers in PubMed, 108 citations in OpenAlex.
- AI-Assisted Scoring Improves Interobserver Agreement in Breast Cancer Biomarker Evaluation.Cancers · 2026Article
- Optimization of Ki67 digital image analysis in breast cancer by automated tumor area identification.Virchows Archiv : an international journal of pathology · 2026Article
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- Revisiting Ki-67 Assessment in Canine Mast Cell Tumours: From Manual Hotspot to Automated Global Analysis.Veterinary sciences · 2026Article
- Ki67 in cytological specimens of pancreatic neuroendocrine tumors: A literature review and validation of automated quantification.Journal of pathology informatics · 2025Article
- Fatty acid-binding protein 4 as a biomarker for colon adenocarcinoma risk and prognosis: Challenges and future directions.World journal of gastrointestinal oncology · 2025Article
- Comparing non-machine learning vs. machine learning methods for Ki67 scoring in gastrointestinal neuroendocrine tumors.Scientific reports · 2025Article
- Deep learning assessment of metastatic relapse risk from digitized breast cancer histological slides.Nature communications · 2025Article
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- Advancing Ki67 hotspot detection in breast cancer: a comparative analysis of automated digital image analysis algorithms.Histopathology · 2025Article
- Assessment of Ki-67 Proliferative Index in Cytological Samples of Nodal B-Cell Lymphomas.Diagnostics (Basel, Switzerland) · 2024Article
- Correlation between Histopathological Prognostic Tumor Characteristics and [Diagnostics (Basel, Switzerland) · 2024Article
- cGAS-STING pathway expression correlates with genomic instability and immune cell infiltration in breast cancer.NPJ breast cancer · 2024Article
- The relation between hypoxia and proliferation biomarkers with radiosensitivity in locally advanced laryngeal cancer.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2023Article
- Glycogen synthase 1 targeting reveals a metabolic vulnerability in triple-negative breast cancer.Journal of experimental & clinical cancer research : CR · 2023Article
- Mechanical Regulation of Mitochondrial Dynamics and Function in a 3D-Engineered Liver Tumor Microenvironment.ACS biomaterials science & engineering · 2023Article
- Stromal tissue segmentation in Ki67 histology images based on cytokeratin-19 stain translation.Journal of medical imaging (Bellingham, Wash.) · 2023Article
- Systematically higher Ki67 scores on core biopsy samples compared to corresponding resection specimen in breast cancer: a multi-operator and multi-institutional study.Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc · 2022Article
- Visual and digital assessment of Ki-67 in breast cancer tissue - a comparison of methods.Diagnostic pathology · 2022Article
- Quantitative Assessment of Epithelial Proliferation in Rat Mammary Gland Using Artificial Intelligence Independent of Choice of Proliferation Marker.The journal of histochemistry and cytochemistry : official journal of the Histochemistry Society · 2022Article
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe Ki67 proliferation index is a prognostic and predictive marker in breast cancer. Manual scoring is prone to inter- and intra-observer variability. The aims of this study were to clinically validate digital image analysis (DIA) of Ki67 using virtual dual staining (VDS) on whole tissue sections and to assess inter-platform agreement between two independent DIA platforms.
methodsSerial whole tissue sections of 154 consecutive invasive breast carcinomas were stained for Ki67 and cytokeratin 8/18 with immunohistochemistry in a clinical setting. Ki67 proliferation index was determined using two independent DIA platforms, implementing VDS to identify tumor tissue. Manual Ki67 score was determined using a standardized manual counting protocol. Inter-observer agreement between manual and DIA scores and inter-platform agreement between both DIA platforms were determined and calculated using Spearman's correlation coefficients. Correlations and agreement were assessed with scatterplots and Bland-Altman plots.
resultsSpearman's correlation coefficients were 0.94 (p < 0.001) for inter-observer agreement between manual counting and platform A, 0.93 (p < 0.001) between manual counting and platform B, and 0.96 (p < 0.001) for inter-platform agreement. Scatterplots and Bland-Altman plots revealed no skewness within specific data ranges. In the few cases with ≥ 10% difference between manual counting and DIA, results by both platforms were similar.
conclusionsDIA using VDS is an accurate method to determine the Ki67 proliferation index in breast cancer, as an alternative to manual scoring of whole sections in clinical practice. Inter-platform agreement between two different DIA platforms was excellent, suggesting vendor-independent clinical implementability.
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